I authorize Persvoyage Travel to charge my credit card the amount of
(total must include delivery fee):

$______________________ Credit Card Type _______________________ Approval Code: ____________________

Credit Card Number: __________________________________________ Exp. Date: __________________________

Card Holder Signature:   __________________________________________________________________________

CARD HOLDER BILLING & SHIPPING INFORMATION

Name:        __________________________________________________

Address:    __________________________________________________

City:           __________________State:___________Zip:_____________

Email:        __________________________________________________

Passenger Name(s) as they appear on their travel documents (Passport):

1    First Name ______________________________________________ Middle Initial: _______________________

      Last Name ________________________________________________________________________________

     Address (If different from Billing/Shipping address): _________________________________________________

     __________________________________________________________________________________________

    Mr./Mrs./Ms./Child: ________________________________________ Date of Birth: ________/_______/________

    Passport Number: ________________________________________  Expiration Dated: _____________________

2    First Name ______________________________________________ Middle Initial: _______________________

      Last Name ________________________________________________________________________________

     Address (If different from Billing/Shipping address): _________________________________________________

     __________________________________________________________________________________________

    Mr./Mrs./Ms./Child: ________________________________________ Date of Birth: ________/_______/________

    Passport Number: ________________________________________  Expiration Dated: _____________________

ROUTING

FROM __________________ TO _________________ TO _________________ TO _________________

Refund/Exchange fee before departure $300.00 each ticket plus difference in fare, Business class $500.00 each ticket. Partially used tickets/No Show is nonrefundable. MartinAir/KLM tickets not fundable. DL/KL/AF refund/exchange fee before departure $350.00 each ticket, Business class $500.00 each ticket. Qatar Airways refund/exchange fee before departure $400.00 each ticket, Business class $600.00 each ticket. Emirates refund fee $300.00 each ticket, exchange fee before departure $500.00 each ticket.

PLEASE PROVIDE THE FOLLOWING INFORMATION:

A. Credit card–Front Side          B. Credit card–Back Side          C. Driver's License, State or Military ID for verification